Smell my pain

Odours Expressible in Language, as Long as You Speak Right Language

It is widely believed that people are bad at naming odors. This has led researchers to suggest smell representations are simply not accessible to the language centers of the brain. But is this really so? Psychologist Asifa Majid from Radboud University Nijmegen and linguist Niclas Burenhult from Lund University Sweden find new evidence for smell language in the Malay Peninsula

English speakers struggle to name odors. While there are words such as blue or purple to describe colors, nothing comparable exists to name odors. Even with familiar everyday odors, such as coffee, banana, and chocolate, English speakers only correctly name the smells around 50% of the time. This has led to the conclusion that smells defy words

Majid and Burenhult conducted research with speakers of Jahai, a hunter-gatherer language spoken in the Malay Peninsula. In Jahai there are around a dozen different words to describe different qualities of smell. For example, ltpɨt is used to describe the smell of various flowers and ripe fruit, durian, perfume, soap, Aquillaria wood, bearcat, etc. Cŋɛs, another smell word, is used for the smell of petrol, smoke, bat droppings and bat caves, some species of millipede, root of wild ginger, etc. These terms refer to different odor qualities and are abstract, in the same way that blue and purple are abstract.

English speakers grapple to describe smells. Their responses for odors were 5 times longer than their responses for colors. This is despite the fact that the smells used in the experiment were familiar to English speakers but not necessarily to the Jahai. For example, English speakers trying to name the smell of cinnamon said it was: spicy, sweet, bayberry, candy, Red Hot, smoky, edible, wine, potpourri, etc.

These results question the view that there is a biological limitation for our inability to name smells. Jahai speakers have an elaborate vocabulary for smells that they use with fluency. This means that the inability to name smells is a product of culture and not biology.

I could just as easily imagine the sentence “English speakers trying to name the smell of cinnamon said it was: spicy, sweet, bayberry, candy, Red Hot, smoky, edible, wine, potpourri, etc.” transformed to “English speakers trying to describe their pain said it was burning, stabbing, aching, grinding, tearing, shooting, gnawing etc.”

We might use different words to describe a smell, but we can share that experience – “here, smell this”.  When it comes to pain, language is really all we have when we try to share our experience of it. Would it help to be able to say to another human being “hey, smell my pain”?

Language is such a powerful output for a human in trouble, and like any other bodily output it can be altered by the experience of pain, become stuck, become impoverished.

Equally, language can act to provide evidence for greater safety, with neuroscience powered education, or danger, with scary sounding diagnoses and fear provoking explanations of injury or pathology (real or imagined).

Language and how we use it is discussed in detail during noigroup courses and David Butler loves to recount the story of a client that once shared with him a very apt proverb; “Reckless words pierce like swords, but the tongue of the wise brings healing”

-Tim Cocks
http://www.noigroup.com

The noigroup faculty is teaching the very finest Explain Pain and Graded Motor Imagery courses all around the globe over the next 12 months, from Doorn in the Netherlands to Derby in the UK.

Meanwhile, Brendan Haslam will be taking the brand new Pain, Plasticity and Rehabilitation course to Portland in January and  David Butler will be touring the US in February. Checkout the noigroup courses page for dates, locations and all other details.

 

5 Responses to “Smell my pain”

  1. John Barbis

    This is not surprising to me. How often do English speaking people (generally more wealthy, urban living, and consumers of rather bland foods) actually use their olfactory senses. I know that after I spend a week or so in the woods, my ability to smell and discriminate odors increases dramatically. I know that most of my persistent pain patients describe pain much more floridly than those who have an acute nocicpetive episode. Is that because of some kind of behavioral problem or is it really because pain/nociception is a much more real existential issue and their brains are adapting to make the distinction? Eskimos have something like 30 different words for snow. It is an important part of their existence. Why shouldn’t they be better at classifying it? If it ain’t important to you and you don’t practice or live it, why should the brain take up space trying to classify it? Johnb

    Reply
  2. davidbutler0noi

    John – I was thinking of your comments this morning while I was making coffee. I have 4 gas burners on my stove but after 10 years I do not know which dial ignites which burner – I just keep fiddling until I get it. I suppose my brain “thinks” – “no need to keep that particular motor/perceptual/memory signature in Dave’s aging and overloaded brain – he is accomplishing what he needs with the dial fiddling technique “.

    I am still pondering those language findings. I think your suggestion Tim, is that we may be able to develope better and more meaningful descriptors of pain? Certainly, pain descriptors are common among aetiologies and there are recent moves to consider studes based on descriptors rather than aetiology or diagnosis. (Baron et al 2012) (eg “burning” pain may give us more information than the aetiologies and diagnoses that it is common to).

    This needs deeper thinking. For example, few people are aware that the words used in the McGill Pain Questionnaire were extracted from words used in the literature, not patients in pain and were then collated into categories by healthy uni students. There are currently no studies that I am aware of which report the specific words and phrases used by people in pain.

    Fertile topic!

    David

    Baron RM et al 2012 Lancet Neurol (11) (11) 999-1005

    Reply
  3. Johan Sloothaak

    Dear mr Butler
    Perhaps i may make a modest contribution.

    “There are currently no studies that I am aware of which report the specific words and phrases used by people in pain.”

    Hopefully i can help on that one:

    Frequency of chronic pain descriptors: Implications for assessment of pain quality
    Chen-Ping Lin a,⇑,1, Amy E. Kupper a, Arnold R. Gammaitoni b, Bradley S. Galer c, Mark P. Jensen
    European Journal of Pain 2011
    The words patients use to describe chronic pain: Implications for measuring pain
    quality
    Mark P. Jensen, Linea E. Johnson, Kevin J. Gertz, Bradley S. Galer, Arnold R.
    Gammaitoni
    Pain 2013
    Exploratory and confirmatory factor analysis of the PROMIS
    pain quality item bank
    Dennis A. Revicki • Karon F. Cook •
    Dagmar Amtmann • Neesha Harnam •
    Wen-Hung Chen • Francis J. Keefe
    Qual Life Res 2013

    May i explain my field of interest:
    I am interested in the phenomenom of a scharp/stabbing pain-experience produced by gentle palpation of the soft tissue. Could this by produced by sensitisized low theshold mechanoreceptors? Could exposure treatment with mechanical interventions (touch, friction, tension and movement…even dry needling) accompanied by CBT and explaining pain be an interesting approach?
    I am working on this in the clinic for several years and have wonderful results with this sub-population of pain-patients. Unfortunately it is difficult to produce a scientific documentation that wil be accepted in the field.
    Noxious mechanosensation – molecules and circuits
    John N Wood and Niels Eijkelkamp
    Current Opinion in Pharmacology 2012, 12:4–8
    Ah-fiber nociceptive primary afferent neurons: a review of incidence
    and properties in relation to other afferent A-fiber neurons in mammals
    Laiche Djouhri*, Sally N. Lawson
    Brain Research reviews 2004
    Peripheral Projections of Nerve Fibres in the Human Median Nerve
    W. J. L. SCHADY, H. E. TOREBJORK and J. L. OCHOA
    Brain Research, 277 (1983) 249-261

    Johan Sloothaak
    info@fysiospecialist-sloothaak.nl

    Reply
  4. davidbutler0noi

    Hi Johan,

    Many thanks for the references. I need to update myself, especially as I note Mark Jensen is one of the main authors you cited and I am teaching a course with him in April!

    As a very broad response:
    “sharp stabbing pain reproduced by gentle palpation” makes me think of a local inflammatory state and/or a centrally constructed mechanical allodynia. In both states but especially the second, upregulation of ion channels locally is likely and may contribute to the overall pain construction.

    I expect you are dealing more with the second group? And as a very broad response, if you will excuse the inherent dualism, a reasonable treatment regime could be considered as “do what is appropriate to the tissues and the representation of the tissues in the brain will full regard for the reciprocal effects” I do think many professionals and patients are addicted to the “magic”of hands on but in an exposure framework and a realisation that major effects will be brain derived rather than tissue derived, its fine in my view.

    I hope you keep in touch (and apologies for my slow response – I have been out of internet range lately!)

    Best wishes

    David

    Reply
    • Johan Sloothaak

      Hi David
      I am glad with your comment. Although the upregulation of ion channels in the mechanoreceptors is probably due to an interaction of peripheral and central mechanisms, i agree with the term centrally constructed mechanical allodynia to differentiate “sharp stabbing pain by gentle palpation” from a purely local nociceptive mechanism. May i reformulate in my own terms the treatment regime you have mentioned : “a functional and mechanically acting intervention on a modest pain level, in a safe and controlled environment, gives the system ( body and patient) sufficient time and information to reconsider its first startle reaction and adapt its warning mechanism to the apparently non-threatning situation”.
      When I read your book “The sensitive nervous system” chapter 2 , especially page 36-42, it feels like coming home. My clinical interpretation of the exposure framework fits in your view of the brain as a constructor of reality connected with your concept that the representations are, in part, input driven (page 38).
      This means in the clinical setting of manual therapy: “As long as the patient haven’t encountered the potential or actual (pain)threatening moment of mechanical interaction, it could be a problem to rearrange the smudged cortical representations and to desensitize the system”.
      In order to come to a save and controlled encounter with the pain revealing situation, it can be necessary to go back to the safe environment of hands-on: touching and guiding the (active) movement.
      To go to the topic “smell my pain”:
      Tim Cocks says: When it comes to pain, language is really all we have when we try to share our experience of it.
      John Barbis says: I know that most of my persistent pain patients describe pain much more floridly than those who have an acute nocicpetive episode.
      Language, with a floridly description and mutual understanding, is possible on the basis of the common experience of a dull, crushing, throbbing pounding sensation after the impact of blunt pressure in contrast to the pricking, stinging, stabbing and sharp sensation as a result of the impact of a (imaginative) protruding object.
      On the basis of that description it is even possible to make an inference about the differentiation of the nerve fiber systems transmitting these pain sensations. Both fiber systems could show difference in their responsiveness to analgetics and probably to other interventions like exposure treatment as well. I expect that A fiber mediated pain will react better on a personal graded exposure treatment.
      Beissner F, et al. Quick description of A-delta and C fiber mediated pain based on three verbal descriptors. PLOS one 2010;5:1-7.

      Best wishes

      Johan

      Reply

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